Medical oncologists serve at the front lines of the war against cancer. From diagnosis to treatment, including support care and beyond, medical oncologists help patients battle the disease. Medical oncologists focus treatments on surgery and chemotherapy, as opposed to radiation oncologists, who use radiation therapy to fight cancer. Though they use different protocols, medical oncologists may work on a team with radiation oncologists and other doctors. It can take more than a decade to become a medical oncologist.
The medical oncologist’s first job is to figure out what kind of cancer she’s dealing with and how aggressive the case is. That means starting with blood or bone marrow tests to analyze the health of immune cells find cancers such as leukemia. She orders imaging tests, such as CT, MRI or PET scans, which take pictures of soft tissues inside the body. Biopsies, either with a needle that draws lymph samples or through surgery to cut away a growth, are part of diagnosis as well. Through microscopic study of the biopsy, the medical oncologist determines cancer type and stage.
Armed with diagnostic details, the medical oncologist writes a treatment plan that includes drugs and chemotherapy, but not surgery or radiation. To shrink tumors before surgery, kill stray cancer cells after an operation or improve the effectiveness of radiation therapy, she prescribes chemotherapy. Therapies that boost immune function and curb inflammation are in her arsenal of treatments as well. Some medical oncologists enter patients into clinical trials to test cancer drugs that aren’t yet on the market. Plus, medical oncologists perform bone marrow transplants.
Cancer patients need care beyond their illness and it's the medical oncologist who coordinates that help. She ensures her patients have medications to reduce pain, nausea or fatigue, and to improve appetite. For patients and families who want emotional counseling, she provides referrals. She may even prescribe antidepressants to boost a patient’s mood. When patients have to make difficult medical decisions, the oncologist provides guidance. And because cancer treatment often is complex, she helps patients navigate the health care system.
Cancer patients often need therapies beyond what a medical oncologist provides. it is the oncologist’s job to team with other doctors and health professionals. The oncologist may refer a patient to a surgeon who removes tumors or a radiation oncologist who uses the technology to kill cancer cells. Medical oncologists also work with oncology nurses, pharmacists, pathologists, dietitians and home health aides to provide care. They consult with rehabilitation therapists to help patients recover their ability to breath, speak or move. For people with a family history of cancer, the medical oncologist consults with a genetic counselor to determine who’s at highest risk for the disease and to intervene before patients get sick.
It can take more than 10 years to earn credentials to practice medical oncology. Like all doctors, medical oncologists need a four-year undergraduate degree, followed by four years of medical school that includes clinical rotations practicing internal medicine, pediatrics, psychiatry and surgery. To become board-certified in medical oncology, a doctor must become board-certified in internal medicine. Board certification in internal medicine requires at least three years of post-medical school residency. For certification in medical oncology, doctors need a two-year residency, with at least 12 months doing bone marrow biopsies, administering chemotherapy and caring for vein catheters. Doctors also have to pass a certification exam. Plus, every state requires doctors to be licensed to practice.